BACK TO BASICS PEDIATRICS, S CORP
NPI 1205310356
Pediatrics in Algonquin, IL
NPI Status: Active since September 24, 2018
Contact Information
2403 HARNISH DR STE 101
ALGONQUIN, IL
ZIP 60102
Phone: (224) 520-0087
- Organization
- Pediatrics
- CLIA Number: 14D2156257
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 10-11-2026
About BACK TO BASICS PEDIATRICS, S CORP
This page provides the complete NPI Profile along with additional information for Back To Basics Pediatrics, S Corp, a pediatrician established in Algonquin, Illinois operating as a Pediatrics. The healthcare provider is registered in the NPI registry with number 1205310356 assigned on September 2018. The practitioner's primary taxonomy code is 208000000X. The provider is registered as an organization and their NPI record was last updated 7 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's other name is Back To Basics Pediatrics, S Corp. The authorized official of this NPI record is Dr. Christine Poulos Md (Pediatrician)
- NPI
- 1205310356
- Provider Legal Name
- BACK TO BASICS PEDIATRICS SC
- Other Organization Name
- BACK TO BASICS PEDIATRICS, S CORP
- Other Name Type
- Other Name (5)
- Entity Type
- Organization
- Location Address
- 2403 HARNISH DR STE 101 ALGONQUIN, IL 60102
- Location Phone
- (224) 520-0087
- Mailing Address
- 2403 HARNISH DR STE 101 ALGONQUIN, IL 60102
- Mailing Phone
- (224) 333-0730
- Mailing Fax
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 09-24-2018
- Last Update Date
- 12-12-2018
- Code Navigator
A pediatrician like Back To Basics Pediatrics, S Corp is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pediatrics
- Taxonomy Code
- 208000000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 14D2156257
- Facility Type
- Physician Office
- Certificate Effective Date
- October 12, 2024
- Certificate Expiration Date
- October 11, 2026
- Laboratory Director
- CHRISTINE M. POULOS M D
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Back To Basics Pediatrics, S Corp to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1205310356, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 44. The final step is to find the difference between that total and the next multiple of ten (50 - 44 = 6).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 44 is 50. The difference is the calculated check digit.
Other Providers at the Same Location
The following 3 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1205310356, enumerated as an "organization" on September 24, 2018.
The provider is located at 2403 HARNISH DR STE 101 ALGONQUIN, IL 60102 and the phone number is (224) 520-0087.
Pediatrics with taxonomy code 208000000X.
